Knowledge of thromboprophylaxis guidelines pre- and post-didactic lectures during a venous thromboembolism awareness day at a tertiary-care hospital
Hasan M Al-Dorzi1, Antoine Cherfan2, Shmylan Al-Harbi3, Ahmad Al-Askar4, Saleh Al-Azzam5, Ahmad Hroub6, Joan Olivier6, Fahad Al-Hameed7, Mohamed Al-Moamary8, Mohamed Abdelaal9, Gregory A Poff10, Yaseen M Arabi1
1 Department of Intensive Care, King Abdulaziz Medical City; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
2 Department of Pharmaceutical Care, King Abdulaziz Medical City-Riyadh, Saudi Arabia
3 Department of Pharmaceutical Care, King Abdulaziz Medical City; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
4 College of Medicine, King Saud Bin Abdulaziz University for Health Sciences; Department of Adult Hematology, King Abdulaziz Medical City-Riyadh, Saudi Arabia
5 Department of Surgery, King Abdulaziz Medical City-Riyadh, Saudi Arabia
6 Department of Nursing, King Abdulaziz Medical City-Riyadh, Saudi Arabia
7 Department of Intensive Care and Ambulatory Care Services, King Abdulaziz Medical City-Jeddah; Saudi Association for Venous Thrombo-Embolism, Riyadh, Saudi Arabia
8 College of Medicine, King Saud Bin Abdulaziz University for Health Sciences; Pulmonary Division, Department of Medicine, King Abdulaziz Medical City-Riyadh, Saudi Arabia
9 Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City; King Abdullah International Medical Research Center-Jeddah, Saudi Arabia
10 Saudi Medical Safety Center, King Abdulaziz Medical City-Riyadh, Saudi Arabia
Yaseen M Arabi
Department of Intensive Care, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 11426
Source of Support: None, Conflict of Interest: None
Background: Didactic lectures are frequently used to improve compliance with practice guidelines. This study assessed the knowledge of health-care providers (HCPs) at a tertiary-care hospital of its evidence-based thromboprophylaxis guidelines and the impact of didactic lectures on their knowledge.
Methods: The hospital launched a multifaceted approach to improve thromboprophylaxis practices, which included posters, a pocket-size guidelines summary and didactic lectures during the annual thromboprophylaxis awareness days. A self-administered questionnaire was distributed to HCPs before and after lectures on thromboprophylaxis guidelines (June 2010). The questionnaire, formulated and validated by two physicians, two nurses and a clinical pharmacist, covered various subjects such as risk stratification, anticoagulant dosing and the choice of anticoagulants in specific clinical situations.
Results: Seventy-two and 63 HCPs submitted the pre- and post-test, respectively (62% physicians, 28% nurses, from different clinical disciplines). The mean scores were 7.8 ± 2.1 (median = 8.0, range = 2-12, maximum possible score = 15) for the pre-test and 8.4 ± 1.8 for the post-test, P = 0.053. There was no significant difference in the pre-test scores of nurses and physicians (7.9 ± 1.7 and 8.2 ± 2.4, respectively, P = 0.67). For the 35 HCPs who completed the pre- and post-tests, their scores were 7.7 ± 1.7 and 8.8 ± 1.6, respectively, P = 0.003. Knowledge of appropriate anticoagulant administration in specific clinical situations was frequently inadequate, with approximately two-thirds of participants failing to adjust low-molecular-weight heparin doses in patients with renal failure.
Conclusions: Education via didactic lectures resulted in a modest improvement of HCPs' knowledge of thromboprophylaxis guidelines. This supports the need for a multifaceted approach to improve the awareness and implementation of thromboprophylaxis guidelines.